The seagull wing self retaining prosthesis in the surgical treatment of pectus excavatum

Background. Between June 1958 and June 1996 we operated many patients affec ted by pectus excavatum with an original surgical technique. In this study we evaluated the durability of the results. Methods. Experimental design: Retrospective study with a mean follow-up tim e of 15.8 years/pt, and 60% com plete. Setting: private and institutional practice. Patients or partecipants: 357 patients (253 males and 104 females, mean age = 18.2+/-5.1 years) affected by pectus excavatum The grade of PE (Chin cla ssification) was I in 76 patients, II in 165 and III in the remaining 116. Most of the patients required operation for aesthetic reasons only (339 pat ients; 95%) Intervention: the surgical technique consisted of a double transversal ster notomy at the level of the lowest and highest part of the depression associ ated with a longitudinal sternotomy. A wedge resection of the ribs was then performed and the sternum was fixed using an original stainless steel stru t prosthesis moulded into a seagull wing. The strut was removed 12 months p ostimplantation. Results. There were no operative deaths. Four patients (1.2%) had sternal w ound infection, which was successfully treated. From the aesthetic point of view, the postoperative results were excellent in 262 patients (73.4%), go od in 82 (22.9%) and poor in 13 (3.6%). All subjective symptoms, when prese nt, disappeared after surgery. Conclusions. The seagull wing prosthesis app ears to be safe, easy to implant and to remove, and comfortable for the pat ient. This technique has shown good long-term results independently of type of deformity and patient age.